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Prevalence of Pre-Existing Hearing Loss Among Patients With Drug-Resistant Tuberculosis in South Africa.

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Title: Prevalence of Pre-Existing Hearing Loss Among Patients With Drug-Resistant Tuberculosis in South Africa.
Authors: Hyejeong Hong1,2 hhong13@jhu.edu, Dowdy, David W.3, Dooley, Kelly E.4, Francis, Howard W.5, Budhathoki, Chakra1, Hae-Ra Han1,6, Farley, Jason E.1,2
Source: American Journal of Audiology. Jun2020, Vol. 29 Issue 2, p199-205. 7p. 1 Diagram, 3 Charts.
Subject Terms: *Audiometry, *Statistical correlation, *Hearing disorders, HIV infection complications, Malnutrition, Age distribution, Aminoglycosides, Chi-squared test, Confidence intervals, Hospitals, Poisson distribution, Regression analysis, Research funding, Risk assessment, Statistics, Ototoxicity, Disease prevalence, Cross-sectional method, Data analysis software, Statistical models, Descriptive statistics, Mann Whitney U Test, Disease complications, Disease risk factors
Geographic Terms: South Africa
Abstract: Purpose: Hearing loss, resulting from aminoglycoside ototoxicity, is common among patients with drug-resistant tuberculosis (DR-TB). Those with pre-existing hearing loss are at particular risk of clinically important hearing loss with aminoglycoside-containing treatment than those with normal hearing at baseline. This study aimed to identify factors associated with pre-existing hearing loss among patients being treated for DR-TB in South Africa. Method: Cross-sectional analysis nested within a clusterrandomized trial data across 10 South African TB hospitals. Patients ≥ 13 years old received clinical and audiological evaluations before DR-TB treatment initiation. Results: Of 936 patients, average age was 35 years. One hundred forty-two (15%) reported pre-existing auditory symptoms. Of 482 patients tested by audiometry, 290 (60%) had pre-existing hearing loss. The prevalence of pre-existing hearing loss was highest among patients ≥ 50 years (adjusted prevalence ratio [aPrR] for symptoms 5.53, 95% confidence interval (CI) [3.63, 8.42]; aPrR for audiometric hearing loss 1.63, 95% CI [1.31, 2.03] compared to age 13-18 years) and among those with a prior history of second-line TB treatment (aPrR for symptoms 1.73, 95% CI [1.66, 1.80]; PrR for audiometric hearing loss 1.33, 95% CI [1.03, 1.73]). Having HIV with cluster of differentiation 4 cell count < 200 cells/mm³ and malnutrition were risk factors but did not reach statistical significance in adjusted analyses. Conclusion: Pre-existing hearing loss is common among patients presenting for DR-TB treatment in South Africa, and those older than the age of 50 years or who had prior second-line TB treatment history were at highest risk. [ABSTRACT FROM AUTHOR]
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Database: Education Research Complete
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Abstract:Purpose: Hearing loss, resulting from aminoglycoside ototoxicity, is common among patients with drug-resistant tuberculosis (DR-TB). Those with pre-existing hearing loss are at particular risk of clinically important hearing loss with aminoglycoside-containing treatment than those with normal hearing at baseline. This study aimed to identify factors associated with pre-existing hearing loss among patients being treated for DR-TB in South Africa. Method: Cross-sectional analysis nested within a clusterrandomized trial data across 10 South African TB hospitals. Patients ≥ 13 years old received clinical and audiological evaluations before DR-TB treatment initiation. Results: Of 936 patients, average age was 35 years. One hundred forty-two (15%) reported pre-existing auditory symptoms. Of 482 patients tested by audiometry, 290 (60%) had pre-existing hearing loss. The prevalence of pre-existing hearing loss was highest among patients ≥ 50 years (adjusted prevalence ratio [aPrR] for symptoms 5.53, 95% confidence interval (CI) [3.63, 8.42]; aPrR for audiometric hearing loss 1.63, 95% CI [1.31, 2.03] compared to age 13-18 years) and among those with a prior history of second-line TB treatment (aPrR for symptoms 1.73, 95% CI [1.66, 1.80]; PrR for audiometric hearing loss 1.33, 95% CI [1.03, 1.73]). Having HIV with cluster of differentiation 4 cell count < 200 cells/mm³ and malnutrition were risk factors but did not reach statistical significance in adjusted analyses. Conclusion: Pre-existing hearing loss is common among patients presenting for DR-TB treatment in South Africa, and those older than the age of 50 years or who had prior second-line TB treatment history were at highest risk. [ABSTRACT FROM AUTHOR]
ISSN:10590889
DOI:10.1044/2020_AJA-19-00103